Individual provider Active NPI

Lindsay Von Bernuth, P.A.

  • Medical Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1629121900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1602 Issued in CO
Practice address
1200 E Elizabeth St
Fort Collins, CO 80524-4007
Phone
(970) 416-6286
Fax
(970) 482-2635
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1602 CO Primary

Addresses

Primary practice location

1200 E Elizabeth St
Fort Collins, CO 80524-4007

Mailing address

1200 E Elizabeth St
Fort Collins, CO 80524-4007
Phone (970) 416-6286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1602COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Collins Youth Clinic Current Accepting new patients

Locations

1214 Oak Park Dr
Fort Collins, CO 80525
Phone (970) 226-6225

1200 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 416-6286

2500 Rocky Mountain Ave
Ste 260
Loveland, CO 80538
Phone (970) 682-3743

2500 Rocky Mountain Ave
Rm 4355
Loveland, CO 80538

4845 Weitzel St
Timnath, CO 80547
Phone (702) 679-5109

Interoperability endpoints

  • Direct secure messaging: lindsayvonbernuth@yc.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629121900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E ELIZABETH ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244007",
            "telephone_number": "970-416-6286",
            "fax_number": "970-482-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E ELIZABETH ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244007",
            "telephone_number": "970-416-6286",
            "fax_number": "970-482-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON BERNUTH",
        "first_name": "LINDSAY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.